Colorado Enacts Healthcare Laws after Legislative Session

Gov. Polis signed several healthcare-related bills into law following the 2026 Colorado legislative session.

• HB26-1019 Kidney Screening Mandatory Preventive Coverage: The bill adds kidney function screening as a mandated preventive service that must be covered at no cost to members. Coverage applies to large group plans issued or renewed on or after January 1, 2027, and to individual and small group plans issued or renewed on or after January 1, 2028, provided the state is not required to defray the cost.
• SB26-006 Parity for Non-Opioid Pain Management Drugs: The act requires health insurers providing prescription drug benefits to apply utilization management rules (including prior authorization and step therapy) for FDA-approved non-opioid pain drugs that are no more arduous than the least restrictive utilization review requirements for opioid drugs prescribed for the treatment or management of chronic or acute pain. Cost-sharing, copayments, and deductibles for non-opioid pain drugs also cannot exceed those of comparable opioid treatments. These provisions take effect 91 days after the Colorado General Assembly adjourns unless a referendum petition under state law occurs. In addition, individual and small group plans issued or renewed on or after January 1, 2027, and large group plans on or after January 1, 2028, must cover at least one clinically appropriate non-opioid alternative to an opioid pain medication.
• SB26-167 Prescription Drug Out-of-Pocket Expense Credit: Beginning January 1, 2028, Colorado individual and group health plan insurers must credit a covered person's out-of-pocket prescription drug purchases directly from a pharmacy or direct-to-consumer platform toward applicable cost-sharing and out-of-pocket maximums. To receive the credit, the individual must submit proof of payment within 90 days of purchase. Insurers may request additional documentation and may deny the credit in certain situations, including when the amount paid exceeds what the individual would have paid for the same drug through an in-network pharmacy under the plan.

Employers with health benefit plans governed by state law should be aware of these mandates and can contact their carrier or TPA for further details.

For more information, read HB26-1019 Kidney Screening Mandatory Preventive Coverage, SB26-006 Parity for Non-Opioid Pain Management Drugs, and SB26-167 Prescription Drug Out-of-Pocket Expense Credit.